WASHINGTON–Legislation creating a universal health care system in the U.S. similar to the system in many states requiring motorists to buy auto insurance was introduced today in the Senate by Sen. Ben Cardin, D-Md.

The legislation would require all Americans to enroll in a health care plan.

The bill was introduced as Democrats both in the House and Senate work to push through different legislative proposals expanding the State Children’s Health Insurance Plan.

Republicans–aided and abetted by the White House–are seeking to reduce the scale of the child health care legislation by claiming it is the first step toward a government takeover of healthcare.

The Senate is expected to start debate this evening on a modest bill that expands SCHIP by $35 billion over 5 years and pays for it by increased taxes on tobacco.

The proposal is expected to win the 60 votes necessary in the Senate to cut off debate and speed action.

A more expansive bill that increases SCHIP spending by $50 billion over 5 years and also increases doctor’s fees under Medicare, among other changes, is expected to be on the House floor later this week.

This bill would be paid by a smaller increase in the tobacco tax as well as cutbacks in payments to the Medicare Advantage program over 4 years.

It also proposes to create a unit within HHS to study the comparative effectiveness of drugs, devices and technologies used in healthcare.

Both bills are operating under a veto threat from the White House.

Cardin’s bill would direct the Secretary of Health and Human Services to work with the National Association of Insurance Commissioners to develop 3 low-cost options for individuals below 400% of the federal poverty level.

The legislation, the Universal Health Coverage Act, would require Americans to have qualified health coverage such as Medicare, Medicaid, SCHIP, veterans’ health care, federal health employee benefits, Indian Health Service or any other qualified health coverage as defined by their state of residence.

Cardin said his proposal “is based on the principle of personal responsibility: namely, that those who have the financial ability to afford health insurance must be required to have it.”

It also maintains the current employer-based system and protects government-sponsored health programs, he said.

Under the bill, those who fail to enroll for any coverage for a continuous period greater than 60 days would be required to pay a tax equal to the average monthly premium amount for qualified coverage as defined by the state in which they reside.

Funds collected by this tax would then be used to automatically enroll them in a state-approved plan.